Patient Access Coordinator

Description

Who We Are

Are you interested in working for an organization whose mission is to enable frail, underserved, and multicultural senior communities to live independently at home and in their communities, for as long as possible?

Fresno Program of All-Inclusive Care for the Elderly (PACE) is dedicated to providing its participants with comprehensive health and social supports that are proven to effectively manage chronic conditions and to reduce the risk for premature institutionalization. PACE staff are leaders in the “aging in place” industry and we have had the honor of serving Fresno, Bakersfield and Orange County seniors and their families/caregivers.

Job Summary

Under the supervision of the Operations Manager, the Patient Access Coordinator is responsible for various aspects of the department including but not limited to order entry, the authorization process, scheduling, and confirmation calls. Responsibilities include collecting all necessary documentation, contacting the referring provider office for additional information and completion of the required prior authorization form in order to proceed with the request. The Patient Access Coordinator will serve as a liaison between patients and medical staff. Must display excellent communication, organization, and follow-up skills with the ability to handle multiple assignments simultaneously. In addition, demonstrates good judgement as well as attention to detail.

Essential Job Functions

Duties include, but are not limited to:

· Works towards the organization’s goal of providing timely outside provider access for our participants. 

· Ensure timely and effective scheduling of new patient consults and/or continuous outside care in accordance with physician 

  and/or office guidelines.

· Obtain prior authorization information in accordance with established guidelines. 

· Verify prior authorizations and/or pre-service requirements are met. 

· Order Entry of Prior Authorization Requests received.

· Timely completion for all prior and retroactive authorization requests.

· Documenting authorization status and demonstrating proficiencies with Electronic Health Records systems.

· Appropriately schedule all specialty appointments

· Coordinate transportation and interpretation services for all specialty appointments as needed.

· Confirm new patients and return appointments in computer system in accordance with physician and/or office guideline.

· Make confirmation calls to both outside providers and participants per office guidelines.

· Provide outstanding customer service to participants and develop and maintain positive working relationships with internal and 

  other external customers. 

· Uses customer service principles and techniques to deal with patients, physicians and medical office staff calmly and pleasantly.

·  Meet or exceed all daily, weekly and monthly production goals.

· Document all activity and correspond to inquiries in a timely manner. 

· Identifies prior authorization trends and/or issues resulting in delayed processing.

· Identifies scheduling trends and/or issues resulting in delays.

· Communicates and works effectively with colleagues from other departments.

· Follows written and verbal communications.

· Follows all Innovative Integrated Health (IIH) health and safety policies and procedures.

· Follows policies and procedures to contribute to the efficiency of the department.

· Performs other administrative tasks and/or projects required to meet performance and customer services standards.

· Performs other related duties as required or assigned.

Requirements

Knowledge, Skills, and Abilities

Computer Skills

· Computer skills including typing and knowledge of applications such as Microsoft Office Suite (Outlook, Word, Excel, PowerPoint, 

  etc.) and Windows is required.

Language Skills

· Ability to effectively present information and respond to questions from management, participants, auditors and coworkers.

Essential Functions

· Track and schedule patient referrals

· Process authorizations

· Order entry for Prior Authorization requests

· Confirmation calls of appointments to both outside providers and participants

Abilities

• Ability to read, understand and follow oral and written instructions.

• Ability to use multi-line phone system, including transferring calls.

• Ability to provide consistent follow-through to guarantee completion of all assigned duties.

• Ability to establish and maintain effective working relationships with patients, phys